Business License Application
Business License Status
| What would you like to do today: |
---
|
| Is this a: |
---
|
| If you are are applying for or renewing a PV liquor License, please select which Series you are applying for |
---
|
Location/Ownership Change
| Date of the location/ ownership change: |
---
|
Business Name and Physical Location
| Business name or Trade Name |
CertaPro Painters of Northern Arizona
|
| Nature of Ownership |
---
|
| Business Street Address (Physical location of the business in the Town of Prescott Valley (cannot be a PO Box) |
8766 E State Route 69 Ste 1,Prescott Valley AZ 86314
|
| is the business location: |
---
|
| Mailing Address (Street name and number only) |
8766 E State Route 69 Suite 1
|
| Mailing Address City, State, & Zip Code |
Prescott Valley AZ 86314
|
| Business Phone Number |
+19287793746
|
| Alternate # (Emergency Phone Number) |
---
|
| Number of Employees |
---
|
| Please choose the most applicable to your business: |
---
|
| Please read carefully through the following list and choose the closest description of your business: |
CONTRACTOR PAINTING
|
| Business Description (Please describe in detail the nature of the business) |
---
|
| Will your business be selling or serving alcohol? |
---
|
| Start of business date |
---
|
| Locations where the business or applicant has operated during the last 5 years: |
---
|
Applicant Information (Must be completed by the person filling out this application)
| Name (First and Last) |
---
|
| Home Address (No PO Boxes) |
---
|
| Phone number |
---
|
| Driver's License Number |
---
|
| Driver's License Expiration Date |
---
|
| Date of Birth |
---
|
| Social Security Number (Last four (4) digits ONLY) |
---
|
Corporation Information
| State in which the LLC was legally established |
---
|
| Name of the Business (if owned by another entity) |
---
|
| 1. Name (First and Last) |
---
|
| Title |
---
|
| Home Street Address (cannot be a PO Box) |
---
|
| Telephone Number |
---
|
| 2. Name (First and Last) |
---
|
| Title |
---
|
| Home Street Address (cannot be a PO Box) |
---
|
| Telephone Number |
---
|
Federal Tax ID or Social Security Number
| Please enter your Federal Tax ID Number |
---
|
Professional Licenses
| Upload File |
---
|
| Professional License or Permit Number & Description |
---
|
Application Affidavit
Commercial Occupancy Permit
Commercial Occupancy Permit Application- Information
| What business is currently, or has most recently, occupied this business site? |
---
|
| if applicable, what other businesses are located in this building or on this site? |
---
|
| # of employees: |
---
|
| Sq. Ft. of general floor area: |
---
|
| Sq. Ft. of public floor area: |
---
|
| # of parking spaces: |
---
|
| Are the parking spaces paved? |
---
|
| # of ADA Handicapped parking spaces: |
---
|
| # of wall mounted business signs: |
---
|
| # of free standing signs: |
---
|
| Is this site landscaped? |
---
|
| Is there outdoor lighting? If Yes, please specify how many. |
---
|
| Do you intend to do any internal/external improvements to the building(s)? If Yes, please describe the type of improvements. (Ex: plumbing, sink, electrical, partitions, etc.) |
---
|
Business Information Continued
| Normal operating schedule: please list operations hours/day & days/week (Ex. 8hrs/day, 7 days per week) |
---
|
| Please check any of the following: Will this facility use __________. |
---
|
| Do you or will you store chemicals on site in excess of normal household quantities? |
---
|
| Do you or will you store or use petroleum or non-petroleum oils or greases in your business? |
---
|
| Do you or will you discharge any wastewater (other than domestic wastes from toilets, showers, etc.) to the sewer system? |
---
|
| If applicable, describe any on-site pretreatment facilities or practices used to remove pollutants from wastewater prior to discharge to the sewer system. |
---
|
Prescott Valley Police Department Business Identification
| Alarm Company Name and Phone Number |
---
|
| 1. Name and Phone Number of the Responsible Party |
---
|
| 2. Name and Phone Number of the Responsible Party |
---
|
Fee Review
(Internal) Late Fees
| Do they need a late fee? |
---
|
